Impact of dental cone-beam computed tomography on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning / Impacto de la tomografía computarizada de haz cónico en el diagnóstico y plan detratamiento preimplantologico de senos maxilares

Objective: To determine the impact of CBCT on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning. Material and Methods: Diagnostic evaluation and treatment plan for the maxillary sinus were evaluated by eight specialists experienced in dental implant placement. Eight panoramic radiographs (PAN) and CBCT examinations were obtained from five adult patients with a specific clinical need for dental implants. Evaluation was performed first on PAN then, at least 2 weeks later, on CBCT. Residual alveolar ridge height, mucosal thickening, radiographic findings and treatment plan were recorded. The confidence level was evaluated for both diagnostic evaluation and treatment plan. The kappa statistic for intra-observer reproducibility and McNemar test were performed. Results: In the diagnostic evaluation, CBCT showed significant impact on the diagnosis of radiographic findings. Availability of CBCT significantly changed the treatment plan, for less invasive treatment, or no treatment need. Observers had significantly greater confidence when using CBCT than PAN, when indicating presence of mucosal thickening and radiographic findings in the maxillary sinus. In addition, CBCT increased confidence in the treatment plan. Conclusion: The present study suggests that CBCT has an impact on the diagnostic evaluation of radiographic findings in the maxillary sinus and on the decision to place implants, owing to misdiagnosis of pathology and planning of more invasive treatments when using PAN. Availability of CBCT also improves clinician confidence. Further studies at higher levels of diagnostic efficacy should be performed, to justify the use of CBCT, by evaluating the actual treatment performed and its outcome.

Objetivo: Determinar el impacto de la tomografía computarizada de haz cónico (CBCT) en la evaluación diagnóstica y el plan de tratamiento del seno maxilar en la planificación de implantes dentales. Material y Métodos: La evaluación diagnóstica y el plan de tratamiento del seno maxilar fueron evaluados por ocho especialistas con experiencia en la colocación de implantes dentales. Se obtuvieron ocho radiografías panorámicas (PAN) y exámenes CBCT de cinco pacientes adultos con una necesidad clínica específica de implantes dentales. La evaluación se realizó primero en PAN y luego, al menos dos semanas después, en CBCT. Se registraron la altura del reborde alveolar residual, el engrosamiento de la mucosa, los hallazgos radiográficos y el plan de tratamiento. Se evaluó el nivel de confianza tanto para la evaluación diagnóstica como para el plan de tratamiento. Se realizó el estadístico kappa para la reproducibilidad intraobservador y la prueba de McNemar. Resultados: En la evaluación diagnóstica, CBCT mostró un impacto significativo en el diagnóstico de los hallazgos radiográficos. La disponibilidad de CBCT cambió significativamente el plan de tratamiento, para un tratamiento menos invasivo o sin necesidad de tratamiento. Los observadores tuvieron una confianza significativamente mayor al usar CBCT que PAN, al indicar la presencia de engrosamiento de la mucosa y hallazgos radiográficos en el seno maxilar. Además, CBCT aumentó la confianza en el plan de tratamiento. Conclusión: El presente estudio sugiere que la CBCT tiene un impacto en la evaluación diagnóstica de los hallazgos radiográficos en el seno maxilar y en la decisión de colocar implantes, debido al diagnóstico erróneo de la patología y la planificación de tratamientos más invasivos al usar PAN. La disponibilidad de CBCT también mejora la confianza del clínico. Se deben realizar más estudios a niveles más altos de eficacia diagnóstica para justificar el uso de CBCT, evaluando el tratamiento real realizado y su resultado.

Tratamiento con HeberFERON® del carcinoma basocelular en la Atención Primaria de Salud en Cuba / HeberFERON® Treatment of Basal Cell Carcinoma in Primary Healthcare in Cuba

Introducción: El cáncer de piel es el tipo de cáncer más frecuente en el ser humano, el carcinoma basocelular es el más común de todos los cánceres de piel (80-90 por ciento). Excepcionalmente producen metástasis, pero pueden causar significativa morbilidad e involucran a edades más jóvenes, se tratan con éxito mediante cirugía, radioterapia, quimioterapia y crioterapia, generalmente en el nivel secundario de salud, sin embargo, estos tratamientos no siempre son posibles o deseables. El HeberFERON® es una combinación de interferones alfa y gamma humanos recombinantes, que ha mostrado producir efectos sinérgicos en la reducción de la proliferación de varias líneas de células cancerosas, esta formulación ha sido aprobada en Cuba para el tratamiento del carcinoma basocelular. Presentación de casos: Se presentaron tres casos con diagnóstico de carcinoma basocelular, localizados en la cara, tratados con HeberFERON®, en dos casos fue observada la desaparición de la lesión al finalizar la tercera semana de tratamiento. En el tercer caso, una mujer de 84 años de edad, al finalizar el primer ciclo de tratamiento, fue reducido el tamaño de la lesión tratada y desapareció otra lesión adyacente que no recibió directamente tratamiento, la lesión residual, en esta paciente, fue valorada por ultrasonido para determinar su extensión y profundidad, en los tres casos las reacciones adversas fueron leves y transitorias. Conclusiones: El HeberFERON® es una opción efectiva y segura para el tratamiento del carcinoma basocelular en la atención primaria de salud en Cuba(AU)

Introduction: Skin cancer is the commonest type of cancer in humans. Basal cell carcinoma is the commonest of all skin cancers, accounting for 80 percent to 90 percent of all cases. Exceptionally, they metastasize, but can cause significant morbidity and involve younger ages. They are successfully treated by surgery, radiotherapy, chemotherapy and cryotherapy, mostly at the secondary level of health. However, these treatments are not always possible or desirable. HeberFERON® is a combination of recombinant human alpha and gamma interferons, which has been shown to produce synergistic effects in reducing the proliferation of several lines of cancer cells. This formulation has been approved in Cuba for treating basal cell carcinoma. Case presentation: Three cases are presented with a diagnosis of basal cell carcinoma, located on the face, treated with HeberFERON®. In two cases, the lesion was observed to disappear at the end of the third week of treatment. In the third case, an 84-year-old woman, at the end of the first cycle of treatment, the size of the treated lesion was reduced and another adjacent lesion disappeared, which did not receive direct treatment. In this patient, the residual lesion was assessed by ultrasound to determine its extension and depth. In the three cases, the adverse reactions were mild and transitory. Conclusions: HeberFERON® is an effective and safe option for treating basal cell carcinoma in primary health care in Cuba(AU)

Tomografía computarizada de haz cónico como examen concluyente de hiperplasia de procesos coronoides bilateral. Reporte de tres casos / Cone beam computed tomography as a conclusive examination of bilateral coronoid process hyperplasia. Report of three cases

RESUMEN La hiperplasia del proceso coronoides (HPC) es un crecimiento exagerado del proceso coronoides. La HPC es poco frecuente y genera limitación asintomática de la apertura bucal debido a la impactación del proceso coronoides con el segmento posterior del hueso cigomático. La HPC es un posible diagnóstico en pacientes con limitación progresiva tanto de la apertura bucal como del movimiento protrusivo mandibular. En el presente artículo, se reportan tres casos de pacientes con limitación de apertura bucal. Mediante examen de tomografía computarizada de haz cónico (TCHC), se observó un aumento de tamaño uniforme de los procesos coronoides, confirmando el diagnóstico de HPC bilateral. La TCHC con campo de visión grande determinó el diagnóstico final, pues mostró la impactación del proceso coronoides con el segmento posterior del hueso cigomático en apertura bucal. Además, la TCHC permitió distinguir entre una HPC y una neoplasia del proceso coronoides y/o estructuras anatómicas vecinas.

SUMMARY Coronoid process hyperplasia (CPH) is an excessive coronoid process growing. CPH is infrequent and produces an asymptomatic mouth opening limitation due to the impaction of the coronoid process in the posterior portion of the zygomatic bone. CPH is a possible diagnosis in patients with both progressive mouth opening and protrusive movement limitations. In the present article, cases of three patients with mouth opening limitation are reported. In cone-beam computed tomography (CBCT) examination, a uniform growing of coronoid processes was observed, which confirmed the diagnosis of bilateral CPH. CBCT with large field of view allowed the determination of the final diagnosis, because the impaction of the coronoid process in the posterior portion of the zygomatic bone during mouth opening could be observed. Furthermore, CBCT allowed to distinguish between CPH and neoplasia of coronoid process and/or neighboring anatomical structures.

Diagnostic accuracy of a charge-coupled device and a photostimulable phosphor plate in detection of non-cavitated proximal caries

Objective: the aim of this study was to compare the diagnostic accuracy of two direct digital radiography systems: the charge-coupled device (CCD) XIOS XG Sirona and the photostimulable storage phosphor (PSP) VistaScan DürrDental, in the detection of non-cavitated proximal caries lesions. materials and methods: in this experimental and cross-sectional study 112 proximal surfaces from 27 molars and 31 premolars with or without proximal caries lesions were evaluated and randomly allocated in a study unit. bitewing radiographs were acquired with a CCD XIOS XG and with the PSP VistaScan. a single x-ray unit was used for both systems. radiographic images were assessed independently by two calibrated radiologists. histological evaluation on a stereomicroscope was used as gold standard. results: sensitivity values were found to be 0.35 for CCD and 0.31 for PSP. specificity values were found to be similar for both systems (0.867). az values showed a low diagnostic accuracy for both sensors: 0.61 for CCD and 0.59 for PSP, no statistical difference was found between these two values (p=0.78). conclusion: both digital radiology systems have a high diagnostic accuracy to detect sound surfaces but low diagnostic accuracy to detect proximal carious lesions.

Oestrus ovis infection of grazing sheep during summer in southern Chile

Oestrus ovis is a botfly whose larvae cause nasal myiasis, an environmental-dependent disease in small ruminants, generating acute and chronic injuries in the cranial cavities of sheep. Chile is a country of the southernmost worldwide distribution of this parasite, and there is few information about. Whence, the objective of this study was to approximate the epidemiological situation of O. ovis infection in Chilean sheep. From December 2009 to March 2010, a total of 87 samples were obtained by necropsy for skull inspection. The larvae were collected, and microscopically identified. The prevalence in the sampled sheep was 60.9%. From those that were infected, 85.7% (18/21) of sheep were 1 to 3 years old, constituting the stratum with the highest prevalence. The difference of infection in females and males was not significant. The high risk of infection seems to be dependent upon the environmental conditions of this southern region, especially during summer when the first larval stage (L1) could be found as the evidence. Therefore, the disease should be considered as a significant problem for this kind of livestock production.